qutenza on the face

[epidural man]

Has anyone tried it?

Thoughts?

I have a patient that has post-herpatic neuralgia on the forehead - thinking about 8% Capsaicin patch.

I can't get this article - but there was this.

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[Timeoutofmind]

I have had good results with ketamine and lido gels to the face for this indication
Also cymbalta
Havent tried the 8% Capsaicin patch.

 

[lobelsteve]

Try it on ourself first.

 

[Orin]

Hmm, haven't tried it but I have a similar V1 distribution PHN that I was looking for treatment options for if the medications fail.

The article suggests feasibility in a small case series and suggests using what looks like Kerlix to hold things in place and protect the eyes, with plaster/compresses specifically mentioned.

I had been thinking Botox vs PRF vs peripheral stim, but I'll see how the patient feels about trying this. It would require some hair shaving for my case.

 

[Ducttape]

A few years ago I called the company pertaining this. They highly recommended no facial application.

 

[epidural man]

A few years ago I called the company pertaining this. They highly recommended no facial application.

did they say why?

 

[Ducttape]

Rash, scarring, not approved were 3 phrases I seem to remember....

It’s been a while

 

[epidural man]

Rash, scarring, not approved were 3 phrases I seem to remember....

It’s been a while

It doesn't seem to scar anywhere else.

But this makes me nervous to try it.

 

[Ducttape]

but it does turn really really red.....

 

[Orin]

From that paper's small case series:

"All reported patients showed transient, mild application-site erythema and burning pain during and a few hours after capsaicin application. However, none of them needed rescue medication and all patients completed the duration of patch application. No further adverse effects were reported and in particular no damage to eyes or mucous membranes occurred."

The product insert's guidance is "Do not apply Qutenza to the face or scalp to avoid risk of exposure to the eyes or mucous membranes."

For the folks I see with facial pain, they'd be happy with scarring if the pain was better.

 

[Ducttape]

what if it turned out like this?